Akademik Veri Yönetim Sistemi
Uluslararası Akademik Geriatri Kongresi, Antalya, Türkiye, 12 - 16 Nisan 2017, ss.103
INFLUENZA A - RELATED ACUTE MYOCARDIAL
INFARCTION IN AN ELDERLY WITH NO PREVIOUS
HISTORY OF CORONARY HEART DISEASE
Hülya Kuşoğlu1, Fahri Fatih Tipi2
1
Acibadem University School of Medicine,ınfectious Diseases And Clinical Microbiology
2
Acibadem Fulya Hospital, Cardiology
Introduction: Influenza infection can lead to complications in patients having underlying cardiovascular diseases. There is increasing
evidence from studies that Influenza infection is associated with acute
myocardial infarction and in patients with known coronary disease
Influenza infection can trigger ischemia. Here we present a patient admitted to the hospital with Influenza A infection who had an ischeamic heart attack but did not have a previous history of coronary heart
disease.
Case presentation :A 72-year-old woman was admitted to the
hospital with fever, headache and dry cough present for 2 days. Her
past medical history included hypertension and hyperthyroidism.
Her physical examination findings were as fever to be 38.9 ºC, blood
pressure 140/80 mmHg., a pharyngeal erythema and rare rhonchi
were heard by auscultation. Cardiac sounds were normal with a
normal sinus rhythm. The laboratory findings on admission were as
leukocyte count 5790 with 77.7% neutrophils, hemoglobin 11.4 g/
dl and platelets as 154.000 . Her renal and liver function tests were
within the normal range. Influenza antigen testing was reported to be
Influenza A positive. No bacterial growth was detected in the blood
cultures at the end of 7 days.. Her chest X-ray on admission showed
no pulmonary infiltrates. She was diagnosed to have Influenza A and
was started to receive oseltamivir antiviral treatment. On her second
day of admission during the night she described chest pain, breathing difficulty, numbness over the fingers and a feeling as if falling
down. Her blood pressure was measured as 164/90 mmHg and ECG
showed a sinus rhythm but nonspecific V1-V3 t-wave changes. Blood
testing for troponin I was found to be 0.133 ng/ml . The troponin I
was found to be 0.103 ng/dl 6 hours later and normal on the next
morning. Her Echocardiography was performed and left ventricular
systolic function was found to be normal with EF as 60%, mild mitral
and tricuspid valve failure, and mild pulmonary hypertension. She
was diagnosed to have non-ST elevation myocardial infarction and
was started losartan, enoxaparin, coraspirin, metoprolol, clopidogrel.
Her chest pain did not occur again under this treatment. Her antiviral
treatment was continued for 5 days and was discharged to have to
undergo coronary angiography. She was also advised to receive yearly Influenza vaccinations which she did not have done this Influenza
season.
Conclusion: Influenza infection can induce ischemic heart attacks
although not diagnosed before. Yearly influenza vaccinations in elderly, especially those having cardiovascular diseases, should be done prevent infection which might later be a trigger an ischemic heart
attack.
Keywords: Influenza A infection, Acute myocardial infarction